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目的分析血浆B型0脑钠肽(natriuretic peptide,BNP)及血清前Ⅲ型胶原(procollagen type Ⅲ,PCⅢ)对不同左心室舒张充盈类型的原发性高血压(高血压)患者的影响。方法入选高血压患者150例,均无收缩功能障碍,根据左心室舒张充盈类型不同分为正常舒张充盈型组、松驰受损型组、假正常充盈型组、限制性充盈型组,所有患者均行多普勒超声心动图检查,用干式快速免疫荧光法定量测定血浆B型BNP浓度,用放射免疫法测定血清PCⅢ浓度。结果①正常舒张充盈型组、松弛受损型组、假正常充盈型组、限制性充盈型组的B型BNP分别为(47±16)pg/mL、(147±24)pg/mL、(206±51)pg/mL、(357±64)pg/ml;正常舒张充盈型组、松弛受损型组、假正常充盈型组、限制性充盈型组PCⅢ分别为(81.5±31.4)μg/L、(107.8±30.8)μg/L、(125.3±37.3)μg/L、(157.4±55.4)μg/L,以限制性充盈型组增高最显著,方差分析显示B型BNP与PCⅢ在高血压患者4组间的差异有统计学意义(F=406.6,P<0.05;F=25.4,P<0.05)。②血浆B型BNP与血清PCⅢ呈正相关(r=0.580,P<0.05)。结论血浆B型BNP及血清PCⅢ可客观反映无收缩功能障碍的高血压患者左心室舒张功能受损程度。
Objective To analyze the effects of plasma B-type natriuretic peptide (BNP) and procollagen type Ⅲ (PC Ⅲ) on patients with essential hypertension (hypertension) with different types of left ventricular diastolic filling. Methods 150 cases of hypertensive patients were selected, no systolic dysfunction, according to the type of left ventricular diastolic filling were divided into normal diastolic filling group, relaxation impaired group, false normal filling group, restrictive filling group, all patients All patients underwent Doppler echocardiography, and plasma BNP level was measured by dry-fast immunofluorescence. Serum PCⅢ concentration was determined by radioimmunoassay. Results ① The B-type BNP levels were 47 ± 16 pg / mL and 147 ± 24 pg / mL respectively in the normal diastolic filling group, the relaxation-impaired group, the normal-filling group and the restrictive filling- 206 ± 51) pg / mL and (357 ± 64) pg / ml, respectively. The PCⅢin normal diastolic filling group, relaxing impaired group, pseudoformal filling group and restrictive filling group were (81.5 ± 31.4) μg / L, (107.8 ± 30.8) μg / L, (125.3 ± 37.3) μg / L, and (157.4 ± 55.4) μg / L respectively. The most significant increase was found in the limited filling group. The differences among the 4 groups were statistically significant (F = 406.6, P <0.05; F = 25.4, P <0.05). ② There was a positive correlation between plasma B-type BNP and serum PCⅢ (r = 0.580, P <0.05). Conclusion Plasma B-type BNP and serum PCⅢ can objectively reflect the extent of left ventricular diastolic dysfunction in hypertensive patients without systolic dysfunction.